crossing96/oncoscreening huggingface dataset:
Quality of care: partial cystectomy for bladder cancer--a case of inappropriate use?	PURPOSE: Partial cystectomy is perceived to be a less morbid, less technically demanding procedure than radical cystectomy, although only select patients (approximately 6% to 10%) are appropriate candidates (solitary tumor in space/time, absence of carcinoma in situ). From a quality of care perspective, overuse of partial cystectomy may signify inappropriate delivery of health care. MATERIALS AND METHODS: Subjects who underwent extirpative treatment for bladder cancer between 1988 and 2000 were identified within the Surveillance, Epidemiology and End Results (SEER, 3,381) registry and the Nationwide Inpatient Sample (NIS, 22,088). Adjusted models were developed to identify clinical factors independently associated with the use of partial cystectomy for bladder cancer treatment within each sample. RESULTS: Among patients who underwent extirpative surgery for bladder cancer, 18% and 20% of those in SEER and NIS, respectively, underwent partial cystectomy. Significant decreases in use between early and later years were noted in both samples (SEER-22% to 13%, NIS-24% to 17%, both p <0.0001). Partial cystectomy was preferentially used in the elderly, those with stage I disease, females and black patients. Furthermore, partial cystectomy was more commonly provided in rural, nonteaching, low volume hospitals. CONCLUSIONS: Trends in national use of partial cystectomy are consistent between the NIS and SEER with 13% to 17% of patients currently being treated with partial in lieu of radical cystectomy. Partial cystectomy is disproportionately used in certain medical centers (nonteaching, rural, low volume) and patient populations (elderly, black, females, stage I disease) reflecting selective referral or overuse.	bladder
The anterior ileal conduit: results of 100 consecutive cases.	PURPOSE: The ileal conduit of Bricker is still widely used for urinary diversion after radical cystectomy for bladder carcinoma. We have modified the standard technique with the aim of reducing the complication rate and facilitating treatment. MATERIALS AND METHODS: We leave the conduit in its natural isoperistaltic anterior position, the ureters are anastomosed in an anterior position on their own side, using a short ileum segment. The incision of the peritoneum is made in a particular manner to allow on its closure to extraperitonealize the anastomoses and the bottom of the conduit and to support and fasten the loop. RESULTS: A total of 100 consecutive patients after radical cystectomy for bladder cancer had anterior ileal conduit. The complication rates were 5% temporary ureteroileal leakage, 1% reoperation rate, 5% long-term stenoses and 3% renal function deterioration. The surgical revision and the treatment of ureteroileal stenoses with anterograde percutaneous ureteral stenting were not complicated procedures. A comparison with conventional Bricker series shows a significant decrease in the complication rate. CONCLUSIONS: The anterior ileal conduit reduces the technique complication rate and facilitates the treatment of complications, and it is a recommended operation for these reasons.	bladder
Identification of occupational cancer risks in British Columbia: a population-based case-control study of 1129 cases of bladder cancer.	OBJECTIVE: We collected information on lifetime occupational histories, smoking, and alcohol consumption from 15,463 incident cancer cases. Occupational risk factors for bladder cancer are presented in this report. METHOD: A matched case-control design was used. All cases were diagnosed with bladder cancers, with controls being internal controls consisting of all other cancer sites, excluding lung and unknown primary. Data were analyzed using conditional logistic regression for matched sets data and the likelihood ratio test. RESULTS: Excess bladder cancer risks was observed in a number of occupation and industries, particularly those involving exposure to metals, including aluminum, paint and solvents, polycyclic aromatic hydrocarbons, diesel engine emissions, and textiles. CONCLUSIONS: The results of our study are in line with those from the literature and further suggest that exposure to silica and to electromagnetic fields may carry an increased risk of bladder cancer.	bladder
Recent developments in advanced urothelial cancer.	PURPOSE OF REVIEW: Metastatic or unresectable urothelial cancer of the urinary bladder has traditionally been treated with systemic chemotherapy, which is most often platinum-based. The long-term survival data and the associated toxicities from this form of therapy have spurred continuing interest in finding novel treatment options for this malignancy. RECENT FINDINGS: Recently, trials of new chemotherapy combinations, many incorporating platinum analogs or deleting platinum entirely, have been reported. None has yet been shown to be superior to cisplatin-based regimens. In addition, recent advances in imaging and laboratory technologies have provided new avenues to understand urothelial cancer behavior and prognosis. These advances provide optimism for improvements in the diagnosis, staging, and ultimately, selection of therapy for patients with urothelial cancer. SUMMARY: This review will summarize recent developments (circa 2004) in the diagnosis and management of advanced bladder cancer.	bladder
Impact of socioeconomic status on bladder cancer outcome.	PURPOSE OF REVIEW: To give an update on the possible influence of socioeconomic status on bladder cancer outcome. RECENT FINDINGS: Research to investigate the impact of socioeconomic status on bladder cancer outcome has increased during the past 2 years. The findings of these studies show that socioeconomic status is a significant predictor of survival in male and female patients presenting with bladder cancer, when death from all causes is considered. Very limited data on the effect of affluence on bladder cancer-specific survival, however, are available. Bladder cancer is the only common malignancy for which women have a worse prognosis than men. Recent evidence suggests that the finding of worse survival in women may be confined to those from more deprived areas. SUMMARY: Bladder cancer outcomes are directly influenced by social deprivation.	bladder
Mitochondria are the primary target in isothiocyanate-induced apoptosis in human bladder cancer cells.	Many isothiocysanates (ITC) are promising cancer-preventive agents, and induction of apoptosis is one of their underlying mechanisms of action. We recently found that caspase-9 was preferentially activated over other initiator caspases in human bladder cancer UM-UC-3 cells. We report here that caspase-9 activation is the major step leading to ITC-induced apoptosis in this cell line. More importantly, our results show that caspase-9 activation by the ITCs may result primarily from mitochondrial damage. Four common naturally occurring ITCs were studied, including allyl ITC, benzyl ITC (BITC), phenethyl ITC (PEITC), and sulforaphane. BITC and PEITC showed more potent mitochondria-damaging ability than the other two ITCs, correlating well with their stronger apoptosis-inducing potentials. Furthermore, BITC and PEITC damaged both the outer and inner mitochondrial membranes. Use of isolated mitochondria allowed us to establish that ITCs, and more importantly their major intracellular derivatives (glutathione conjugates) at concentrations that are readily achievable in cells, damage mitochondria, leading to the collapse of mitochondrial trans-membrane potential and release of cytochrome c. The mitochondria-damaging potencies of the ITCs correlate well with their lipophilicities. Bcl-2 family members are known to influence the stability of mitochondrial membrane. Our results show that the ITCs caused phosphorylation of Bcl-2, induced mitochondrial translocation of Bak, and disrupted the association of Bcl-xl with both Bak and Bax in mitochondrial membrane, indicating that ITC-induced mitochondrial damage results at least in part from modulation of select Bcl-2 family members.	bladder
Role of the beta1-integrin subunit in the adhesion, extravasation and migration of T24 human bladder carcinoma cells.	The abilities of tumor cells to extravasate from the blood vessel system and to migrate through the connective tissue are prerequisites in metastasis formation. Both processes are chiefly mediated by integrins, which mediate both cell-cell and cell-matrix interactions. We investigated the role of integrin subunits in the adhesion, extravasation and migration of the highly invasive human bladder carcinoma cell line T24. Here we show that inhibition of the beta(1)-integrin subunit using the specific beta(1)-integrin blocking antibody 4B4 significantly reduces the adhesion to HUVEC and transmigratory activity of T24 cells. The blockade of the beta(1)-integrin subunit also resulted in a significantly reduced locomotory activity of T24 cells. A detailed cell migration analysis on a single cell level revealed that blockade of the beta(1)-integrin subunit leads to an altered migration pattern of single cells but does not influence migration per se. Migration parameters such as time active, velocity and distance migrated were significantly reduced as compared to untreated control cells. Our observations strongly suggest a central role for the beta(1)-integrin subunit in forming the cell-cell and cell-matrix bonds necessary for adhesion, extravasation and migration.	bladder
Fascin-1 expression in papillary and invasive urothelial carcinomas of the urinary bladder.	Fascin-1 is an actin-bundling protein that plays an important role in cell motility and adhesion. The level of fascin-1 is low or undetectable in normal epithelial cells. However, overexpression is reported in transformed epithelial cells and in several common types of carcinomas [Bioessays. 2002;24:359-361]. Up-regulation of fascin-1 is associated with higher grades and with aggressive tumors with poorer prognoses. We found no report on the role or the protein expression of fascin-1 in urothelial carcinomas (UCs) of the urinary bladder. In this study, we examined by immunohistochemistry the expression of fascin-1 in the normal human transitional epithelium, benign vesical lesions, and different types of UCs. We found no detectable fascin-1 in the normal transitional epithelium. There was no increase of fascin-1 expression in cystitis cystica, cystitis glandularis, nephrogenic adenoma (n = 10), inverted papilloma (n = 5), and classic exophytic papilloma (n = 4) or in adjacent transitional epithelia associated with these conditions. Patchy or diffusely weak fascin-1 expression was observed in 42% (5/12) of superficial papillary UCs (Ta), and 95% (19/20) of invasive UCs (T2 or higher) demonstrated diffuse strong staining for fascin-1. The microinvasive foci in the lamina propria of UC (T1, n = 8) were also positive for fascin-1, although they were not as strongly stained as in the deeply invasive tumors. Interestingly, the neoplastic cells in the tips of microinvasive carcinomas were distinctly positive for fascin-1. There were significant numbers of fascin-1-positive cells (>50% of the neoplastic cells) in UCs in situ (n = 10). These findings suggest an association between increased fascin-1 expression and increased invasiveness of carcinomas in the urinary bladder.	bladder
Percutaneous management of upper-tract transitional cell carcinoma.	The gold standard treatment for supravesical urothelial carcinoma has been open radical nephroureterectomy based on the premise that this cancer is a field defect. However, nephroureterectomy is an extensive procedure that may not be tolerated by all patients. Percutaneous and ureteroscopic approaches have been utilized in an attempt to avoid the potential morbidity associated with traditional open surgery. This review provides an update on percutaneous management of upper-tract urothelial transitional-cell cancer based on a review of the pertinent literature.	bladder
[Use of analgesics and aspirin in a Spanish multicenter study].	OBJECTIVE: To evaluate the use of acetaminophen (paracetamol), aspirin and dipyrone (metamizol) in a multicenter study. PATIENTS AND METHOD: We analyzed the controls of a hospital-based case-control study (n = 1029) of bladder cancer using a matrix of drugs and active principles. The admission diagnosis of the study controls was not associated with chronic analgesic use. A logistic regression model was used. RESULTS: Eight percent of the controls were regular users of aspirin, 5% regularly used acetaminophen and 2% regularly used dipyrone. Aspirin was more frequently used by subjects with at least secondary education (OR = 2.0; 95% CI, 1.52-2.93). Women more frequently used acetaminophen (OR = 1.91; 95% CI, 1.30-2.80) and dipyrone (OR = 2.80; 95% CI, 1.49-4.47). Subjects under 65 years old more frequently used dipyrone. CONCLUSION: Chronic use of aspirin and acetaminophen is lower than that reported in North America or northern Europe and is similar to that seen in southern Europe. Differences in the pattern of analgesic use were found among sociodemographic population groups.	bladder
Modification of N-Methyl-N-Nitrosourea initiated bladder carcinogenesis in Wistar rats by terephthalic acid.	The effect of terephthalic acid (TPA) on urinary bladder carcinogenesis was examined. Male Wistar rats were initiated by injection of N-Methyl-N-Nitrosourea (MNU) (20 mg/kg b.w. ip) twice a week for 4 weeks, then given basal diet containing 5% TPA, 5% TPA plus 4% Sodium bicarbonate (NaHCO3) or 1% TPA for the next 22 weeks, and then euthanized. 5% TPA treatment induced a high incidence of urinary bladder calculi and a large amount of precipitate. Though 5% TPA plus 4% Sodium bicarbonate (NaHCO3) and 1% TPA treatment did not induce urinary bladder calculi formation, they resulted in a moderate increase in urinary precipitate. Histological examination of urinary bladder revealed that MNU-5% TPA treatment resulted in a higher incidence of simple hyperplasia, papillary or nodular hyperplasia (PN hyperplasia), papilloma and cancer than MNU control. MNU-5% TPA plus 4% Sodium bicarbonate (NaHCO3) and 1% TPA treatment increased slightly the incidence of simple hyperplasia and PN hyperplasia (not statistically significant). The major elements of the precipitate are phosphorus, potassium, sulfur, chloride, calcium and TPA. The present study indicated that the calculi induced by TPA had a strong promoting activity on urinary bladder carcinogenesis and the precipitate containing calcium terephthalate (CaTPA) may also have weak promoting activity on urinary bladder carcinogenesis.	bladder
Correlation between annual volume of cystectomy, professional staffing, and outcomes: a statewide, population-based study.	BACKGROUND: The association between high procedure volume and lower perioperative mortality is well established among cancer patients who undergo cystectomy. However, to the authors' knowledge, the association between volume and perioperative complications has not been studied to date and hospital characteristics contributing to the volume-outcome correlation are unknown. In the current study, the authors studied these associations, emphasizing hospital factors that contribute to the volume-outcome correlation. METHODS: Multiple-variable models of inpatient mortality and complications were developed among all 1302 bladder carcinoma patients who underwent cystectomy between January 1, 1999 and December 31, 2001 in all Texas hospitals. General estimating equations were used to adjust for clustering within the 133 hospitals. Data were obtained from hospital claims, the 2000 U.S. Census, and databases from the Center for Medicare and Medicaid Services and the American Hospital Association. RESULTS: Complications were reported to occur in 12% of patients, 2.2% of whom died. Mortality was higher in low-volume hospitals compared with high-volume hospitals (3.1% vs. 0.7%; P < 0.001); mortality in moderate-volume hospitals was reported to be intermediate (2.9%). After adjustment for advanced age and comorbid conditions, treatment in high-volume hospitals was associated with lower risks of mortality (odds ratio [OR] = 0.35; P = 0.02) and complications (OR = 0.53; P = 0.01). Hospitals with a high registered nurse-to-patient ratio also had a lower mortality risk (OR = 0.43; P = 0.04). CONCLUSIONS: Mortality after cystectomy was found to be significantly lower in high-volume hospitals, regardless of patient age. Referral to a hospital performing greater than 10 cystectomies annually is indicated for all patients. However, patients with poor access to a high-volume hospital may derive similar benefit from treatment at a hospital with a high-registered nurse-to-patient ratio. This finding requires further confirmation.	bladder
shRNA-targeted hTERT suppress cell proliferation of bladder cancer by inhibiting telomerase activity.	RNA interference (RNAi) has demonstrated profound prospect in human gene research. hTERT, the rate-limiting component of telomerase activity, is highly expressed in bladder cancer cells. Here, we investigated the anti-proliferation effects of small hairpin interfering RNA (shRNA)-targeted hTERT gene on bladder cancer in vitro and in vivo. The results showed that ph2-shRNA, the most-effective vector carrying shRNA-targeted hTERT, could significantly inhibit the cell proliferation by down-regulating hTERT expression, decreasing telomerase activity, decreasing cell number of S phase, increasing the cell number of G0/G1 phase in T24 cells and xenograft tumor tissues, and attenuate the tumor growth of xenograft mice model compared with controls. Our results demonstrate that hTERT-directed shRNAs are potent inhibitors of bladder cancer.	bladder
[Predictive value of progression of muscularis mucosae and percentage G3 cells in vesical TIG3 tumours].	INTRODUCTION AND OBJECTIVE: Vesical tumor T1G3 constitutes the border between the superficial tumor and the infiltrante tumor. Some of these tumors do not respond to BCG and progress, with cystectomy that present poor results, patients who would benefit from a precocious and aggressive treatment if we could identify them in an preinvasive stage. New predictive factors try to select to these tumors, being little the works that consider anatomo-pathological meticulous study (substanding of the T1 in T1a and T1b and percentage of present G3 cells in the tumor). Our objective is to analyze the value of these anatomo-pathological considerations like predictive factors of progression. MATERIAL AND METHODS: Retrospective study of a series of 91 patient affection of vesical tumor T1G3 with initial treatment by means of RTU and BCG. We analyzed 12 variables. The new predictive factors: the level of invasion respect to muscularis mucosae and the percentage of G3 cells. By means of logistic regression analisys we establish the independent pronostic factors for tumoral progression. RESULTS: A total of 31 patients presented infiltration of detrusor, passing away 17 of tumoral cause, after an average time of pursuit of 57.8 +/- 28.2 months. In 8 cases (9%) the substanding could not be determined. The rate of progression for T1a tumors was of 20% (8/40) and for T1b 53% (23/43). Presented independent predictive value of progression the multiplicity (odds: 7.26), the size (odds: 2.14), the presence of Cis (odds: 1.42) and the subestanding (odds: 6.81). CONCLUSION: The substanding is a predictive factor of progression clinically useful in vesical tumors T1G3, reason why we considered habitual clinical introduction.	bladder
Enhanced transgene expression in urothelial cancer gene therapy with histone deacetylase inhibitor.	PURPOSE: Efficient adenoviral infection requires the presence of the coxsackievirus and adenovirus receptor (CAR). We determined whether the histone deacetylase inhibitor FR901228 (Fujisawa Pharmaceutical Co., Ltd., Osaka, Japan) increases the efficiency of adenoviral gene therapy in bladder cancer in vivo and in vitro. MATERIALS AND METHODS: Cytotoxicity studies were performed to determine a minimally cytotoxic FR901228 concentration for bladder cancer cells. The level of CAR expression was determined by fluorescence activated cell scanning and/or reverse transcriptase-polymerase chain reaction analysis in FR901228 treated bladder cell lines. The in vivo effect on adenoviral gene expression was investigated in athymic mice. RESULTS: The concentration of FR901228 showing no or minimal cytotoxicity that was selected for these studies was 0.5 ng/ml for bladder cancer cells. Treatment of cancer cells with 0.5 ng/ml histone deacetylase inhibitor increased CAR RNA levels and acetylated histone H3. This increase was associated with a 5 to 10-fold increase in adenoviral infection, as evidenced by increased transgene expression from a beta-galactosidase containing adenoviral vector. Intravenous administration of FR901228 enhanced CAR expression in athymic mice. The combination of p53 adenovirus and histone deacetylase inhibitor resulted in significant tumor inhibition in vitro and in vivo. CONCLUSIONS: Nontoxic doses of the histone deacetylase inhibitor FR901228 increased CAR RNA levels and resulted in the marked enhancement of transgene expression after adenoviral infections. FR901228 pretreatment may increase the sensitivity of tumor cells to adenoviral gene therapy vectors.	bladder
The impact of provider volume on outcomes from urological cancer therapy.	PURPOSE: Growing evidence suggests an association between higher hospital and surgeon volumes, and better outcomes after high risk surgical procedures. We reviewed the literature on volume and outcomes, specifically in urological cancer therapy. MATERIALS AND METHODS: We searched the literature from 1966 to 2004 using MEDLINE with the keywords outcomes, urology, neoplasms, volume, hospital volume, surgeon volume, prostatectomy, cystectomy, nephrectomy, prostate cancer, bladder cancer, kidney cancer and testis cancer. Relevant articles were reviewed and results were compared for each urological cancer. RESULTS: Several studies demonstrated that higher hospital volume is associated with better outcomes for all urological cancer surgeries. We found that long-term morbidity associated with radical prostatectomy is significantly associated with individual surgeon volume. There were variations in outcome even among high volume surgeons, suggesting that surgical technique can independently impact outcome. Hospitals with a high volume of cystectomies and nephrectomies had decreased overall mortality rates compared with low volume hospitals. Patients undergoing retroperitoneal lymph node dissection for metastatic germ cell tumor had statistically significantly improved survival when treated at larger oncology centers. CONCLUSIONS: Evidence that high volume hospitals have better outcomes is increasing for urological cancer surgeries. Whether volume affects quality or better clinicians and services attract more patients can be debated. Centralizing health care will have major health policy implications, ie high volume hospitals may be overwhelmed and low volume hospitals may be at a disadvantage. An alternative would be to attempt to improve outcomes at low volume hospitals by identifying drivers of high quality care at high volume hospitals and transferring some of these characteristics.	bladder